Headaches are the most common problem after a concussion. There are a variety of types of headaches that can occur after a concussion. Largely, they are similar to the types of headaches that occur in the non-concussed population. However, those who have sustained concussions sometimes have other concussion-related problems – like those mentioned in this handbook – that make treating the headaches more challenging.
Some patients will have little or no problems with PTH and others have more problems. The task of the healthcare team is to navigate through those challenges to help you set things right again. Until the headaches permanently resolve, there are many things you can try to help cope with the symptoms of PTH.
1. Simple Interventions:
a. Apply a cold or hot back to the neck or head
b. Tie something tight around the head
c. Stretching and massaging the head and/or neck and shoulders
d. Perform breathing exercises
e. Visualization or other mindfulness-based exercises
f. Go to a quiet place
g. Lie down
h. Go outside to get some fresh air
a. Avoid skipping meals, delaying meals, eating too few calories or eating an unbalanced diet. All of these can trigger and/or exacerbate headaches.
b. Specifically, a high-protein breakfast can help with PTH.
c. Remain hydrated as previously discussed.
d. Some who have been diagnosed with post-traumatic migraines may find that certain foods trigger their headaches, examples being:
- Red wine
- Aged cheese
- Certain meat: ham, turkey, hot dog
- Certain nuts: almonds, walnuts, cashews
- Alcohol (especially if aged in wood container)
- Foods containing tyramine or nitrites
- Certain beans: chickpeas, Garbanzo
3. Sleep: Managing your sleep as already discussed.
4. Stress Management: See “Maintaining a Positive Attitude” and “Executive Functioning and Rest Strategies”.
a. When medically cleared for the same.
b. Perform cardiovascular exercise, started as advised by your healthcare team and increased gradually in its duration and intensity.
c. Examples include brisk walking, riding a stationary bike (perhaps not facing a visually stimulating scene for some), jogging, elliptical machine, swimming, etc.
d. If your exercise is too much relative to your caloric intake or your sleep quantity/quality, it may also make your headaches worse.
a. You can try the following if your GP or healthcare team approves:
i. Tylenol, Tylenol #1 or #2
ii. Aspirin (not in children)
iii. NSAIDs (e.g. ibuprofen, naproxen)
b. You should use these over-the-counter medications on no more than 15 occasions per month or you run the risk of developing something called medication-overuse headaches; this complicates about 42% of PTH. Make sure to track your use of these medications and use as little as possible.
c. Your use of these medications should be greatly reduced by the 2 weeks mark after having sustained your concussion.
7. Healthcare services: If you have any of the issues outlined on the subsequent pages, treating them will help improve PTH. Examples include:
a. Massage therapy, Manual therapy, Acupuncture
b. Vision and/or vestibular therapy
c. CBT, relaxation therapy
d. Various forms of biofeedback
e. Allopathic medication